Wiki Reciprocal Billing vs Locum Tenens

[ccook]

I am looking to clarify the rules for reciprocal billing and locum tenens billings. Our office has 2 scenarios we are not sure of. One is a military physician covering on occassional weekends for a physician. This occurred over a 6 - 9 month period, where the coverage was for 3 weekends total. What rules would apply? Scenario 2 is a physician that is a Hospice Director but also attending physician on some of the patients, has another physician cover a few times throughout the year. Does the claim get billed under the Hospice physician as locum tenens or would the covering provider submit the claim under hospice? Any help with this is greatly appreciated. Thank you

 

[fredabrinson]

Reciprocal and Locum Tenens

Hello fellow Coder!

I looked this info up for a chapter member several months ago. Here is the info from that time according to the Georgia Part B carrier.

"A patient's regular physician may have reciprocal arrangements with one or more physicians to substitute for him/her on an occasional reciprocal basis. This type of arrangement is common and does not have to be in writing. Medicare will not pay for services beyond a continuous 60-day period.
A locum tenens arrangement is a written agreement between the regular physician and a substituting physician that allows the regular physician to bill and receive payment for the substitute physician's services as though the regular physician had performed the services. Medicare will not pay for services beyond a continuous 60-day period."

Here is the website link to an online course:
www.cahabagba.com/part_b/education_and_outreach/online_courses/incident_to/page399.html

I hope this helps!
Freda
Savannah, GA